3655
92
COLONIAL PENSIONS, &c.
21976
HEOP
PARTICULARS required to be furnished in reference to Persons recommended for Superannuation, Compensation or Compassionate Allowances, or Gratuities on retirement.
(In filling up this Paper refer to the Instructions on page 4.)
1. Name of Applicant.
G. R. Clarke.
2. Office or Situation
3. Recommended for.
4. Age
2nd Class European Infantry in the Govt.
Gratuity
35 years.
5. Service in Years and Months
6. Annual Salary or Wages
7. Emoluments
of $40.
of
One year and nine months.
(actual) per annum - $480 - Free quarters.
Total amount of Salary or Wages and Emoluments on which Superannuation, &c., is claimed,.. $480.
8. Cause of Retirement... ill health - /med certif:
9. Dates of Commencement and Termination of the several Appointments held by Applicant, with their Emoluments, distinguishing Salary from other Allowances and specifying such Allowances.
Title of Appointment. Date of Commencement. Date of Termination. Nature of Allowances, &c. Salary. Allowances. 2nd Class European Infantry 1887 30 June $480 Vil-